APC Policy Dialogue and Nigeria’s Health Sector

The new government can’t afford to put an unqualified person at the helm of affairs of the health sector knowing fully well all the recommendations made by the transition committee and the APC Policy Dialogue on health. The government will be a laughing stock if a wrong person is chosen. In another article I emphasized […]

The new government can’t afford to put an unqualified person at the helm of affairs of the health sector knowing fully well all the recommendations made by the transition committee and the APC Policy Dialogue on health. The government will be a laughing stock if a wrong person is chosen. In another article I emphasized that “the 1st litmus test of this government’s commitment, whether it is serious or not, is to implement what it promised to achieve in health  is the person President Buhari appoints as minister of health”.
In this article we will mention all that the APC Dialogue agreed to implement in the spirit of promoting transparency and accountability. The dialogue entitled ‘From Vision to Reality – Policy Dialogue on Implementation of the Agenda for Change’ was convened May 20th – 21st 2015 at Transcorp Hilton Hotel, Abuja, Nigeria.
In the dialogue report the chapter ‘Achieving Qualitative & Affordable Healthcare highlighted that “Nigeria’s healthcare sector is in need of reform. Lackluster infrastructure, inequality in access to services, poor medical personnel training and equipment, rampant corruption and failure to pass and implement crucial reforms have resulted in Nigeria’s healthcare system lagging behind when most countries are on key on the health indicators. This is negatively impacting Nigeria’s potential growth.
As a first initiative, improving access, accuracy and availability of health related data is required to establish a baseline for target setting and results tracking. Active engagement of states and local government areas (LGAs) for reforms will be crucial to ensure effective implementation.”
I am happy the new government is aware of the following as contained in the report:
•Low life expectancy: 53 years vs 71 years in Egypt
•High infant mortality: 85 per thousand live births vs 15-20 in Egypt
Key challenges in the health sector as identified by the dialogue were:
•Insufficient funding: Health expenditure accounts only for 3% of GDP vs. 11% for South
•Africa; US$400m required to fund vaccinations per year, but currently FG does not have resources.
•Inadequate Infrastructure: Only 3,500 hospitals (of which 950 public) serve a population of 175m with an average of 5 beds per 100,000 persons vs. world median of 35 beds.
•Poor implementation: Weak governance of existing health acts and policies and poor execution from FG to state and LGA levels.
•Unclear accountabilities and coordination: Poor coordination in policy implementation between FG, states and LGA.
•Poor or inexistent information systems: No credible data remains a major constraint limiting accountability of institutions, inability to really understand the situation and drive decisions.
•Prevalence of strikes: Significant loss of health care productivity as a result of frequent workers strikes on contract and compensation disputes.
•Security crisis: Boko Haram crisis has resulted in the shutdown of 37% of primary health facilities in affected areas.
•Adverse impact of the economic situation in Nigeria: Devaluation of the naira is expected to have adverse impact on imported drug and medical equipment prices
•Drug supply and accessibility at risk: Import restrictions on locally produced drugs could result in inadequate supply as limited domestic capacity exists to meet demand leading to higher prices.
 
With the challenges itemised above Nigerians have already gotten a baseline to hold this government to account and to monitor performance across relevant thematic areas.
Interestingly the dialogue already proposed the new government ‘100 Day Covenant’ as follows:
•Introduce a well-managed and properly funded healthcare delivery system
•Free healthcare for children (less than 12) and free treatment for infectious diseases
•Introduce and disseminate national healthy living programme to improve life expectancy
•Raise health practitioner ratio
•Encourage active health investment and partnership programmes
•Perform baseline study to clarify current situation and identify potential efficiency gains
•Define relevant KPIs for healthcare agenda and set up mechanism for monitoring results; leadership of key institutions to be held accountable for results
•Find funding for strategic vaccination programmes such as polio eradication
•Identify healthcare best practices across states and determine best way to share findings
We have already covered 1/3rd of the 100 days. Is the new government on track?
On a mid-term (3 to 18 months) basis, the dialogue proposed to:
•Accelerate the expansion of health insurance coverage and thus access to basic services through the mobile national health insurance programme
•Consider amending the NHIS law to make health insurance compulsory for all Nigerians, after financial impact assessment.
And on a long-term (18 months +) proposed to:
•Reform the Ministry of Health and reduce the number of agencies from 14 to 3 based on alignment of scope and deliverables
•Refocus the federal institution on polices, regulatory and financing of health care and hold agencies, states and LGAs accountable for the delivery of core public health services.
All the aforementioned are doable but they require not just commitment and interest but a genuine desire of the new government to appoint someone capable, qualified, and skilled as Minister of Health who will lead a capable team to stir actions needed for improved services and quality of care.
All comments to Dr Aminu Magashi Publisher Health Reporters ([email protected])